Event registration

Details

Wellington Wallabies Wheelchair Basketball Club

Date TBA

PCYC Wellington, 69 Gobolion St, Wellington NSW 2820

Are you attending this event?

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Basic details

First name*

Last name*

Phone number*

Email address*

Address*

Additional information

Date of birth*

Are you bringing your own sports chair?*

Will you be inviting any family or friends?*

Dietary requirements.* Max 255 characters

Emergency contact name*

Emergency contact number*

Other Information we may need to know Max 255 characters

I am over 18, or, if I am under 18, this registration has been filled out by and endorsed by my parent or guardian.*

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Partners

Transport for NSW

Mogo Wheelchairs

Stacks Goudkamp

Freedom Motors Australia

Forward Ability

Independent Mobility & Rehab

Cauliflower Club

NSW Australia Day Council

Charity Challenge

Stuart Alexander

Blacktown City Council

We Support

Pride in Sport

Play By The Rules